Showing 191 - 200 of 431 annotations tagged with the keyword "Professionalism"

One of These Days

Garcia Marquez, Gabriel

Last Updated: Sep-05-2006
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

Aurelio Escovar is introduced as a poor dentist without a degree. He is busy polishing false teeth early one morning when the mayor arrives to see him. At first he refuses to see this would-be patient, until the mayor, who has been suffering severe toothache for five days and is desperate, threatens to shoot him. Eventually the dentist lets him in, examines him, and then removes the infected wisdom tooth, without anesthesia.

We realize that the dentist has deliberately made the mayor suffer all this time, and he gives the reason as he pulls out the tooth, saying "Now you’ll pay for our twenty dead men." When the mayor has recovered and wiped his tears, he leaves, telling the dentist to send the bill. When Escovar asks whether to send the bill "To you or the town?," the mayor replies, "It’s the same damn thing."

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Annotated by:
Duffin, Jacalyn

Primary Category: Literature / Nonfiction

Genre: Autobiography

Summary:

In 1996, at the age of 31, David Biro is preparing for his specialty examinations in dermatology and is set to share a practice with his father. But he develops a visual disturbance. After repeated testing, he is found to have the rare blood disorder of paroxysmal nocturnal hemoglobinuria. The diagnosis was problematic, but the treatment choices are overwhelming. His youngest sister is a suitable donor, and he opts for a bone marrow transplant. He realizes that his decision was influenced not only by the diagnosis, but also by his personality and his reaction to the physicians.

Advance preparations are hectic and sometimes comic, especially his deposits at a local sperm bank. The pain of the transplant and the six weeks imprisonment in a small hospital room are told in graphic detail. The athletically inclined doctor suffers many complications: exquisitely painful ulcers of the scrotum, mouth, and esophagus; inflammation of the liver; unexplained fever; drug-induced delirium; weakness and weight loss.

His parents, sisters and friends leap into action to provide round-the-clock presence, but his independent wife, Daniella, resents the invasion. While David’s body is wracked with drugs and radiation, his family and his marriage are subjected to destructive forces too. Yet all--body, family, and marriage--emerge intact, though changed, by their experience.

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Middlemarch

Eliot, George (Marian Evans)

Last Updated: Sep-01-2006
Annotated by:
Moore, Pamela

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Middlemarch is a middle-sized country town typical of rural British life in the early nineteenth century. George Eliot (born Mary Ann Evans) was part of the realist school that dominated Victorian literature. She tried to create a true representation of the real, historical lives of ordinary people.

The novel has a vast number of characters and events but most of the plot centers on two couples: Dorothea and Casaubon (later Will Ladislaw) and Rosamond and Lydgate. Dorothea is an intelligent, vigorous woman, eager to improve the lives of her friends and the poor. She is determined not to marry any of the local, mindless squires but to devote herself to godly work.

Soon, however, she is introduced to Casaubon. Casaubon is an aging, ugly scholar, but Dorothea is attracted by his learning and agrees to marry him in hopes of helping him in his work. Their marriage is unhappy and cold. It is contrasted to Dorothea’s growing relationship with Will Ladislaw, a distant relative of Casaubon. Where Casaubon is cold, Will is passionate. Casaubon senses the kinship between his wife and Will and adds a codicil to his will insisting that if Dorothea and Will marry after his death than Dorothea must give up Casaubon’s house and money.

Shortly thereafter, Casaubon does die, and Dorothea is outraged upon hearing of the codicil. She does not recognize her feelings towards Will as feelings of love. By the end of the novel, however, the two confess their feelings and Dorothea gives up her earthly possesssions to live happily.

The plot developed around Lydgate and Rosamond is of particular medical interest. Lydgate is a new kind of medical practitioner. At the beginning of the nineteenth century, the traditional medical order, consisting of physicians (like modern consultants), surgeons, and apothecaries, was being replaced. New well-schooled general practitioners could perform all these functions.

When Lydgate arrives in Middlemarch with his modern techniques and visions of building a modern hospital for the poor, the medical establishment greet him with jealousy and suspicion. Lydgate’s practice therefore develops very slowly. His marriage to Rosamond, a woman used to a rich lifestyle, quickly depletes his savings.

Facing bankruptcy and the loss of his disappointed wife, Lydgate receives an unexpected loan from Bulstrode, a wealthy landowner. Soon after, Bulstrode is charged with murder and Lydgate is accused of having a hand in it; Middlemarch sees the loan as a payoff. Disgraced, Lydgate cannot fight back. He becomes a doctor who toadies to the wealthy and abandons his revolutionary dreams. He dies at 50.

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Montana 1948

Watson, Larry

Last Updated: Sep-01-2006
Annotated by:
Willms, Janice

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This little novel is the retrospective tale of a childhood event told by the protagonist 40 years later. Family relationships and bonds in conflict with professional and community obligations vie with the shadow of racism and sexual abuse in the doctor/patient relationship for the core tensions in the book. The setting is a small rural community where the pioneer family about which the tale evolves controls the law and the medicine. The boy narrator relates his view of the breakdown of family as its secret--a physician uncle who is suspected of sexually abusing his native-American women patients--becomes a force that demands action from the doctor’s brother who serves as the sheriff.

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Medicine: The Art of Healing

Nuland, Sherwin

Last Updated: Sep-01-2006
Annotated by:
Shafer, Audrey

Primary Category: Visual Arts / Painting/Drawing

Genre: Art with Commentary

Summary:

The author selected 48 works of art, famous and obscure, which are presented in chronological order as full-page color plates. On the facing page of each piece is a brief essay which includes information such as artist, date and current location of the work. The essays, as well as the introduction by the author, are insightful, well-written, and demonstrate the author’s vast knowledge as a medical historian. Selections include the "Oath of Hippocrates", Studies of the Fetus by da Vinci, The Anatomy Lesson of Nicolaes Tulp by Rembrandt, The Dwarf Sebastian de Morra by Velazquez, "Muscle-Man from Vesalius" by van Calcar, and First Operation Under Ether by Hinckley (see art annotation in this database).

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Nightwood

Barnes, Djuna

Last Updated: Sep-01-2006
Annotated by:
Willms, Janice

Primary Category: Literature / Fiction

Genre: Novel

Summary:

This strange little tale, set in western Europe, revolves around the shifting relationships among an Irish doctor, a would-be Austrian baron, a circus performer, and the American woman, Robin, who is to become the nemesis of them all. The plot is unfolded in a long series of conversations, many convoluted by their stream-of-consciousness style, rather than in observed action.

The physician (it is never clearly stated that he is a fully trained physician but the point is probably moot, since he assumes the role), the most consistently present and verbal character, is a study in contradictions. He is essentially never portrayed in a classic physician role, but much is made of his profession. This may be explained by the fact that it is his profession that justifies his central position--he knows and is in the confidence of all other characters. The reader follows, by means of the long and complex dialogues, Robin’s systematic destruction of a chain of male and female lovers in what appears to be an obsessive desire for self-destruction.

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New Bridge over the Missouri

Khan, Jemshed

Last Updated: Sep-01-2006
Annotated by:
Belling, Catherine

Primary Category: Literature / Poetry

Genre: Poem

Summary:

This poem, written in five sections of free verse, begins with the speaker remembering the old steel bridge he used to drive over on his way to work. He describes how the gaps between the steel beams had given him access to the world beyond the bridge: he had been able to see the river bank and railroad tracks and, most importantly, the people down there, "wild dangerous men" living near the edge of the river.

The poet next describes the new bridge, with its smooth speedy surface and solid concrete sides concealing the view. He then steps back and reflects: "what now?" He compares the engineer making the bridge with his own writing, "diminish[ing] the homeless to a poetic abstraction," and asks where this leaves him. Both bridge and abstraction, he implies, take the life, untidy and dangerous but valuable, out of his experience of crossing the Missouri.

He cannot view the material for his poetry now, unless he were to stop, back up the traffic, and risk his life climbing the walls of the bridge, and even then he does not know what he would say, because the new bridge has made him realize something about himself: "I am partly the leech come to feed, / yet I cannot waver from my groove." As a poet, he needs access to the lives of others, an access he likens to parasitism. But his career, the work to which he is going, requires him to speed on across the bridge without pausing.

He now elaborates on his distance from the world of the homeless people (and, by implication, all the other material for his poetry), saying that he has "safely bled away the guilt, / and pity and compassion," from his involvement or complicity in the meaning of his material, and "channeled it" into the poem. The leech image is now applied to the poem which, once filled with those ambivalent emotions, becomes separate from the poet and attaches itself instead to the reader, who now becomes the one feeding on the "dark spurt of old blood," the horrifying riches of which the speaker has rid himself.

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Mount Misery

Shem, Samuel (Stephen Bergman)

Last Updated: Sep-01-2006
Annotated by:
Sirridge, Marjorie

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In this sequel to his earlier seem-autobiographical novel, House of God, Shem (this time using both his pseudonym and his real name) describes the experience of a physician in the first year of a psychiatry residency in a prestigious private psychiatric hospital. In this first hand account it is assumed that the author is the resident, Dr. Roy Basch; he describes not only his experiences with a variety of patients but also with the other doctors and the staff members of the institution. It is not a happy place and in the telling of the story there is a biting irony and a sense of the absurd.

It is obvious from the first that Dr. Basch is very serious about becoming a psychiatrist but that he is also searching for meaning and connections. He finds that colleagues may often hurt you more than your patients. Another issue addressed is that of competing psychiatric theories, particularly the competition between pharmacologic treatment and psychoanalysis. Issues about drug treatment trials and the questionable way in which they are conducted also receive attention, as does the problem of insurance coverage for hospitalization.

The fact that psychiatrists often specialize in their own defects becomes a reality to Dr. Basch. There are not many exemplary people in this book--hopefully it exaggerates the real situation. There is, surprisingly, a sort of poignant positive ending.

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Milk

Pollack, Eileen

Last Updated: Sep-01-2006
Annotated by:
Squier, Harriet

Primary Category: Literature / Fiction

Genre: Short Story

Summary:

This is a story about Bea, a single woman professor who has just had a caeserian section for an 11 pound boy, and her hospital roommate, Corinne. Bea describes her own discomfort with Corinne’s race, while admiring Corinne’s pride and nurturance toward her newborn son. As the story progresses, Corinne is betrayed by the medical world in a multitude of ways: misdiagnosis, racist treatment, denial of medical treatment, and incompetent care, resulting in Corinne’s sepsis and her son’s eventual death.

At the end of the story, after Corinne and Bea are discharged from the hospital, Bea tries to visit Corinne and deliver the pictures of her child that Corinne hadn’t been able to afford. But at the last minute, Bea turns away. Although she wants to help, she feels wholly inadequate, and believes she will only cause Corinne pain. Ironically, Bea remembers her last night in the hospital, how she covered her ears as Corinne’s baby whimpered, and as her own breasts surged with milk for the crying child. Even though her instincts and body tell her what to do for Corinne, she is not able to listen.

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Midwives

Bohjalian, Christopher

Last Updated: Sep-01-2006
Annotated by:
Belling, Catherine

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In March, 1981, in Vermont, Charlotte Bedford goes into labor. She has decided to give birth at home with the help of a midwife, Sybil Danforth, but complications develop. Charlotte has a seizure, her heart stops, and she does not respond to CPR. The fetus is still alive, so Sybil delivers him successfully by Cesarean section, with a kitchen knife. But the bleeding when Sybil makes the incision convinces her assistant that the patient’s heart was still beating. She reports this to the police and Sybil is put on trial for involuntary manslaughter.

The story of the trial is told by Sybil’s daughter, Connie, fourteen years old at the time and now an obstetrician-gynecologist. The acquittal comes at a price: the midwife finds herself no longer capable of delivering babies, and both she and her daughter are given a new insight into the uncertainty which underlies so many of medical decisions. At the end of the novel we are left uncertain whether or not Charlotte was still alive when her baby was delivered.

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